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Original Investigation |

Changes in Retail Prices of Prescription Dermatologic Drugs From 2009 to 2015

Miranda E. Rosenberg, BA1; Steven P. Rosenberg, MD2
[+] Author Affiliations
1The Perelman School of Medicine at The University of Pennsylvania, Philadelphia
2Department of Dermatology, The Miller School of Medicine at the University of Miami, Miami, Florida
JAMA Dermatol. 2016;152(2):158-163. doi:10.1001/jamadermatol.2015.3897.
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Importance  Physicians from many specialties as well as primary care prescribe dermatologic medications; as insurance formularies become increasingly restrictive and more patients are covered with high-deductible insurance plans, many patients are forced to pay high retail prices to obtain their medications.

Objectives  To determine the changes in the prices of commonly prescribed dermatologic medications since 2009 and to identify trends in price increases for different classes of drugs.

Design, Setting, and Participants  Four national chain pharmacies received surveys requesting price data on commonly prescribed dermatologic drugs in 2009, 2011, 2014, and 2015. The initial survey requested information on 72 brand-name drugs. Subsequent surveys increased to eventually include 120 additional brand-name drugs and their generic alternatives when available. Owing to the frequency of prescription, diseases treated, or unusual price increases, 19 brand-name drugs surveyed in all 4 years were selected for final price trend analysis, which was conducted from August 1 to 15, 2015.

Main Outcomes and Measures  Retail prices of topical and systemic drugs for the treatment of various dermatologic conditions.

Results  Prices of surveyed brand-name drugs increased rapidly between 2009 and 2015. Of the 19 brand-name drugs analyzed, the retail prices of 7 drugs more than quadrupled during the study period. Among these 19 drugs, the mean price increase was 401% during the 6-year survey period, with the majority of the price increases occurring after 2011. Prices of topical antineoplastic drugs had the greatest mean absolute and percentage increase ($10 926.58 [1240%]). Prices of drugs in the antiinfective class had the smallest mean absolute increase ($333.99); prices of psoriasis medications had the smallest mean percentage increase (180%). Prices of acne and rosacea medications increased a mean of 195%, and prices of topical corticosteroids increased a mean of 290% during the study period. Selected generic drugs surveyed in 2011 and 2014 also increased a mean of 279% during the 3-year period.

Conclusions and Relevance  The price of prescription dermatologic drugs rose considerably from 2009 to 2015, with the vast majority of price increases occurring after 2011. Percent increases for multiple, frequently prescribed medications greatly outpaced inflation, national health expenditure growth, and increases in reimbursements for physician services.

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Figure 1.
Mean Prices of Brand-Name Drugs by Therapeutic Category

The mean price across the 4 surveyed national pharmacy chains (Costco, CVS, Sam’s Club, and Walgreens) of brand name drugs in each therapeutic category for survey years 2009, 2011, 2014, and 2015. The graph demonstrates the relative magnitude of increase for each therapeutic category.

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Figure 2.
Mean Prices of Acne and Rosacea Drugs

The mean price across the 4 surveyed national pharmacy chains (Costco, CVS, Sam’s Club, and Walgreens) of Benzaclin, Finacea, Oracea, Retin-A Micro, 0.1%, and Tazorac cream, 0.1%, in 2009, 2011, 2014, and 2015. The prices of these drugs more than doubled; the price of Retin-A Micro more than quadrupled between 2009 and 2015.

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Figure 3.
Mean Prices of Psoriasis Drugs

The mean price across the 4 surveyed national pharmacy chains (Costco, CVS, Sam’s Club, and Walgreens) of Oxsoralen-Ultra, Taclonex, and Soriatane in 2009, 2011, 2014, and 2015. The prices of these drugs increased substantially during this time frame; the price of Oxsoralen-Ultra more than quadrupled between 2009 and 2015.

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Figure 4.
Mean Prices of Generic Drugs

The mean prices across the 4 surveyed national pharmacy chains (Costco, CVS, Sam’s Club, and Walgreens) of generic drugs in survey years 2011 and 2014. The prices of some of these drugs remained relatively unchanged during this time frame, while the prices of others increased substantially; the price of nystatin-triamcinolone (Mycolog-II cream) increased 10-fold. The nonproprietary names for the remaining generic drugs are as follows: for Aclovate, alclometasone; Lidex cream, fluocinonide; Locoid cream, hydrocortisone butyrate; Lotrisone cream, clotrimazole-betamethasone; Retin-A cream, tretinoin; and Topicort cream, desoximetasone.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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